Re: POLITICS History and Acceptance of Diet-Heart/Lipid Hypotheses (was Re: 1907-2007.. who gets the credit for longevity ..?)

[Guest guest]

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> > Let's not discount the inherent significance of ideas.

> Certainly, but it's also important to remember that ideas generally

> need support and nourishment to persevere. It's a rare idea that's so

> compelling that it seemingly takes over all by itself, and I'd argue

> that even those ideas are generally ones whose time has come, so to

> speak -- IOW, ideas which fell on ground which was essentially pre-

> prepared for them. Ancel Keys' personal motivations are certainly

> interesting, but they're beside the point in a larger sociological

> sense. The question is what were the forces that promulgated and

> supported his idea, not why he personally was so attached to it.

> History is full of people who had unpopular ideas and died bitter

> because nobody ever listened to them -- to the degree they're even

> written about at all. When someone has an idea which is very

> conducive to profit, however, those parties which stand to profit will

> often put every bit of their weight behind it, and often enough they

> even have a part in the initial development of the idea.

Keys' personal motivations are quite relevant in this case, because it

was his own ascendancy to power in the Ameircan Heart Association that

spearheaded the diet-heart campaign.

The vegetable oil industry certainly stood to make massive profits

from the diet-heart hypothesis (while not necessarily the lipid

hypothesis per se), and they certainly did not fail to take full

advantage of the hypothesis as it emerged.

However, the beef and dairy and egg industries stood to suffer huge

losses. The fact that the vegetable oil industry stood to gain profit

cannot explain why its financial interests triumphed over thsoe of

other industries. The principal difference, from what i have read, is

that the diet-heart hypothesis and lipid hypothesis were promoted with

public funds and endorsed by government institutions.

The following information is from chapter 10 of Colpo's _The Great

Cholesterol Con_.

In 1n 1957, the AHA produced a scathing critique of the diet-heart

hypothesis that was 12.5 pages with 87 references concluding the

evidence was very poor. In 1961, it produced a 2-page report with 23

references concluding the evidence was good enough to make dietary

recommendations. The difference was three of the five members who

wrote the original report were replaced. One of the new members was

Keys himself.

Through the 1960s, the American Medical Association called the

anti-fat, anti-cholesterol campaign a foolish and futile fad that

carried some risk.

In 1959 the FDA concluded the evidence for the hypothesis was poor,

and in 1965, the FDA ruled that labeling an oil as preventing heart

disease because it lowers cholesterol was misbranding under the Food,

Drug and Cosmetic Act.

Meanwhile, Senator McGovern established the Select Committee on

Nutrition and Human Needs in 1968 for the purpose of wiping out

malnutrition. By the 1970s, it had established a series of landmark

food assistance programs.

Since bureacracies never die, the committee did not stop when it

reached its public assistance goal. The general counsel of the

committee told Taubes, " We really were totally naive, a bunch of

kids, who just thought, 'Hell, we should say something on this subject

before we go out of business.' " McGovern and other senators were

following the prudent diet at the time and endorsed the effort.

In 1977, the committee released its first publication of Dietary

Goals, which mirrored AHA recommendation. It came up against wide

criticism from the beef, dairy and egg industries, which served to

prove the point of the report's authors in the public eye -- that it

was unbiased public funds working in the public interest against the

financial interests of private industry.

The Natioal Academy of the Sciences heavily criticized the science of

the report. But it lost its credibility when proponents of the lipid

and diet-heart hypotheses pointed out that 2 of 12 members who wrote

the NAS report were consultants to the beef and egg industries, and

the NAS in general received its funding through industry donations.

What finally served to PROVE the lipid hypothesis in the eyes of the

FDA, the media, and most of the scientific and medical community, was

the Coronary Primary Prevention Trial. This was put on by a branch of

the National Institutes of Health with $150 million dollars of public

funds.

(Now, from Steinberg's book...) Before this trial, the FDA had not

approved cholesterol-lowering drugs. In fact, the cholestryamine that

was used in the trial had been FDA-approved to treat primary biliary

steatosis but not cholesterol-lowering. It was the CPPT that

convinced the FDA to approve drugs based on their cholesterol-lowering

effect, which paved the way for the approval of the statins. Of

course, private industry had been manufacturing statins since 1980,

but it was not until the results of this publicly funded " clincher "

trial were available in 1985 that the way was paved for the incredibly

profitable statin industry.

> > But to reduce it merely to the flow of money

> > seems very simplistic to me and probably seriously flawed.

> Following the money doesn't reduce anything to the mere flow of money;

> it follows the money through human hands and observes the influence of

> money on human behavior. To discount money is to discount a powerful

> incentive which has a profound effect on human activity.

I agree, but the phrase " follow the money " implies that the flow of

money is almost a deterministic force. I'm not critcizing a straw man

-- I think this generally Marxist way of viewing history is pretty

popular now.

Clearly, money is a huge motivator. The question is, why was the

vegetable oil successful at promoting its financial interests and the

beef/dairy/egg industries unsuccessful at promoting their financial

interests during the ascendancy of the diet-heart hypothesis?

I think part of the answer lies in the fact that the originally

successful experimental inductions of atherosclerosis in animals used

fatty animal foods. Part of it were independent occurrences of

history that might not have any clear deterministic explanation -- for

example, what motivated Keys to join the AHA, or why his application

got approved, etc. The overrrding factor appears to be the fact that

the publicly funded and publicly endorsed government committee's and

institutes endorsed the idea, and their perceived pursuit of the

public interest without regard to profit gave them much more

credibility than private industries, some of whom stood to profit and

some to suffer losses by the ascendancy of the theory. And of course

the opposite alignment of profit and loss would have held if a

different theory -- such as red meat prevents heart disease -- were

being promoted.

Chris